(03) 8415 1907
(03) 8415 1907
(03) 8415 1907
(03) 8415 1907
(03) 8415 1907

ELBOW SURGERY

Total Elbow Replacement (Elbow Arthroplasty)

Replacing the damaged elbow joint to relieve pain and restore movement

Total elbow replacement surgery, also known as elbow arthroplasty, is performed to treat severe elbow joint damage that causes persistent pain, stiffness, instability or loss of arm function. The procedure involves replacing the damaged joint surfaces with specialised prosthetic components designed to improve movement, reduce pain and restore functional use of the arm. Total elbow replacement is typically recommended when joint damage is advanced and non-surgical treatments are no longer providing adequate symptom relief. The procedure may assist patients who experience difficulty with everyday activities such as lifting objects, personal care tasks, or using the arm for work or recreation.

On this page, you will learn how elbow arthritis and joint damage are assessed, when total elbow replacement surgery may be recommended, how the procedure is performed, what to expect during recovery and rehabilitation, the potential risks, and how to safely return to daily activities following surgery.

1. What conditions may require total elbow replacement surgery?

Total elbow replacement surgery may be considered for several conditions affecting the elbow joint, including:

Severe elbow arthritis

  • Osteoarthritis (degenerative arthritis)
  • Rheumatoid arthritis and other inflammatory joint conditions
  • Post-traumatic arthritis following previous injury
  • Early gentle elbow movement

Complex elbow fractures

Some fractures involving multiple joint surfaces or severe bone damage may not be suitable for fixation and may require joint replacement to restore function.

Failed previous elbow surgery

In some cases, persistent pain or instability following previous fracture fixation or ligament reconstruction may require replacement surgery.

Chronic elbow instability or joint destruction

Severe joint damage or instability that cannot be reconstructed using other surgical techniques may be managed with elbow arthroplasty.
Dr Richard Dallalana performs a comprehensive assessment to determine whether elbow replacement surgery is appropriate based on joint damage, bone quality, age, activity level, and functional goals.

2. How total elbow replacement surgery works

The elbow joint is formed by three bones:
  • The humerus (upper arm bone)
  • The ulna (forearm bone)
  • The radius (forearm bone)

Total elbow replacement surgery involves removing damaged cartilage and bone from the joint surfaces and replacing them with artificial components that recreate joint movement. Most elbow replacements involve a prosthetic hinge system that allows bending and straightening of the elbow while maintaining joint stability.

3. Preparing for total elbow replacement surgery

Careful surgical planning is essential to support optimal outcomes.

Pre-operative preparation typically includes:

Clinical Assessment

Dr Dallalana will assess:

  • Elbow pain severity and movement restriction
  • Joint stability and strength
  • Nerve function and arm alignment
  • Impact on daily function and quality of life

Imaging Investigations

Imaging may include:

  • X-rays to assess joint damage and alignment
  • CT scans to evaluate bone quality and joint structure
  • MRI in selected cases to assess surrounding soft tissues

Medical Optimisation

Preparation may also involve:

  • Reviewing medications
  • Managing medical conditions that may affect healing
  • Pre-operative physiotherapy education
  • Discussion of post-operative expectations and activity modifications

Patients are usually provided with fasting instructions and surgical admission planning prior to surgery.

4. Understanding the prosthesis used in total elbow replacement

During total elbow replacement surgery, the damaged joint surfaces are replaced with artificial components known as a prosthesis. These components are designed to replicate the natural movement of the elbow joint while providing stability and reducing pain.
The prosthesis typically consists of:
  • Humeral Component - This component is inserted into the upper arm bone (humerus). It replaces the damaged joint surface and forms one side of the new elbow joint.
  • Ulnar Component - This component is inserted into the ulna (one of the forearm bones). It connects with the humeral component to allow controlled bending and straightening of the elbow.
  • Hinge Mechanism - Most modern elbow replacements include a linked or semi-linked hinge design. This allows movement while providing stability, particularly when ligaments or joint structures have been damaged by arthritis or trauma.
Implant fixation may involve surgical cement or press-fit techniques depending on bone quality and surgical planning.
The artificial joint is designed to:
  • Restore smooth elbow movement
  • Reduce joint friction and pain
  • Improve arm positioning and functional use
  • Provide stability when surrounding soft tissues are weakened

5. How long does an elbow replacement prosthesis last?

Elbow replacement implants are designed to function for many years. Prosthesis longevity varies between individuals and may depend on:
  • Activity level
  • Bone quality
  • Surgical technique
  • Adherence to post-operative activity recommendations

Because elbow replacements are smaller and experience different loading forces compared to hip or knee replacements, patients are usually advised to avoid heavy lifting or repetitive high-load activities to help protect implant longevity.

Selection of the most appropriate prosthesis depends on several patient-specific factors, including:
  • Severity and pattern of joint damage
  • Bone quality and anatomy
  • Ligament stability
  • Age and functional requirements
  • Previous elbow surgery or injury
Dr Richard Dallalana carefully assesses these factors when planning elbow replacement surgery to support safe joint function and long-term outcomes.

6. How total elbow replacement surgery is performed

Total elbow replacement surgery is typically performed under general anaesthesia and may be combined with regional nerve blocks to assist with post-operative pain management.

Surgical approach

A carefully positioned incision is made at the back of the elbow to allow safe access to the joint while protecting surrounding nerves and soft tissues.

Joint surface preparation

Damaged cartilage and bone are removed from the humerus and ulna. The joint surfaces are reshaped to allow placement of prosthetic components.

Implant placement

Artificial components are inserted into the humerus and ulna. These components are typically connected through a hinge mechanism designed to allow controlled joint movement while maintaining stability.

Fixation may involve:

  • Specialised surgical cement
  • Press-fit implant techniques in selected cases

Soft tissue balancing

Ligaments and soft tissues are assessed and adjusted to ensure joint stability and smooth movement following implantation.

Wound closure and protection

The incision is closed and the elbow is placed in a protective splint or brace to support early healing.

7. Hospital stay and immediate recovery after elbow replacement surgery

Patients usually remain in hospital for monitoring, pain management, and early rehabilitation.
Early recovery focuses on:
  • Pain control using medications and regional anaesthesia
  • Monitoring nerve and circulation function
  • Protecting the surgical repair
  • Gentle early movement under supervision
The length of hospital stay varies depending on individual health and recovery progress.

8. Recovery timeline after total elbow replacement surgery

Recovery following elbow arthroplasty is gradual and carefully guided to protect the prosthesis and surrounding tissues.
First 2 weeks after surgery
  • Elbow splint or brace protection
  • Wound healing and swelling management
  • Gentle supervised movement exercises may begin
  • Gradual increase in elbow movement
  • Physiotherapy focusing on safe joint motion
  • Avoid lifting, pushing, or heavy arm use
  • Progressive strengthening exercises
  • Increasing functional arm use for daily activities
  • Continued strengthening and endurance training
  • Return to many daily activities may be considered

Full recovery timelines vary depending on joint damage severity, overall health, and rehabilitation progress.

9. Long-term activity restrictions after total elbow replacement

Unlike some other joint replacements, elbow replacements require lifelong activity modifications to protect implant longevity.
Patients are usually advised to avoid:
  • Heavy lifting
  • Repetitive high-impact loading
  • Contact or collision sports
Dr Dallalana provides individual guidance on safe long-term activity levels.

10. Potential risks and complications of total elbow replacement surgery

All surgical procedures carry potential risks. These will be discussed in detail prior to surgery and may include:
  • Infection
  • Implant loosening or wear over time
  • Nerve irritation or injury
  • Elbow stiffness
  • Instability or mechanical complications
  • Fracture around the implant
  • Need for revision surgery in the future
Careful surgical technique, rehabilitation planning, and activity modification aim to reduce these risks.

11. Expected outcomes following total elbow replacement surgery

Many patients experience:
  • Significant reduction in pain
  • Improved elbow movement
  • Enhanced ability to perform daily activities
  • Improved quality of life
Functional improvement depends on pre-operative joint condition, muscle strength, and adherence to rehabilitation and activity recommendations.

12. Individualised surgical planning for elbow arthroplasty

Total elbow replacement surgery requires detailed surgical planning and personalised rehabilitation strategies.
Treatment planning considers:
  • Severity of joint damage
  • Bone quality and anatomy
  • Nerve function and soft tissue stability
  • Age and activity requirements
  • Overall health and healing capacity
Dr Richard Dallalana focuses on tailoring surgical technique and recovery planning to support safe rehabilitation and long-term elbow function.

13. When to contact the practice after elbow replacement surgery

Patients should seek medical advice if they experience:
  • Increasing pain, swelling, or redness around the wound
  • Fever or signs of infection
  • Sudden loss of elbow movement or strength
  • New numbness or nerve symptoms
  • Concerns regarding splint or wound healing
Early review allows prompt assessment and management of potential complications.

14. Booking a consultation for total elbow replacement surgery

If you have severe elbow arthritis, complex elbow injury, or persistent elbow pain and stiffness affecting daily activities, specialist assessment can help determine whether elbow replacement surgery may be appropriate. Dr Richard Dallalana provides comprehensive assessment and management of elbow joint conditions, offering both non-operative and surgical treatment options tailored to individual patient needs.
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